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NORMAL - what does it mean to you? This word seems to mean very different things to different people and especially, in different situations.
How many of us here would say we are normal?
What if asked to evaluate your own intelligence - would you say your intelligence level or ability is "normal"?
Is normal average. Certainly the word average constitutes the majority, and isn't it the majority that determines what is normal? Is normality simply fitting within the confines of the majority - in other words, being average?
I. Basic Issues
A. What is "abnormal" behavior?
1. Contributes to maladaptiveness in an individual
2. Considered deviant by a culture (thus it is culture specific)
3. Leads to personal psychological distress
4. unusual, rare, but not necessarily bizarre
B. What are some common myths about abnormality?
1. Bizarre
2. Different in kind
3. dangerous
4. Shameful
5. Self-induced
C. A Closer Look at each component
1. Maladaptive Behavior
a) an inability to handle daily life events
For example, many people drink, but when drinking interferes with
social and/or professional life it can be considered maladaptive.
b) this is a very important component in diagnosing problems such as
drug abuse
2. Deviant Behavior
a) behavior that falls outside the boundaries deemed acceptable by a
culture
For example: *men wear kilts in Scotland
*living arrangements in villages in Papua New Guinea
3. Personal Psychological Distress
a) not necessarily overt behavior...reports of feelings of sadness,
anxiety, etc., to friends and/or family.
b) important in determining and diagnosing psychological disorders
4. Unusual but not necessarily bizarre
like deviant behavior, this is often governed by the culture. But,
now we also include personal history, experiences, race, religion,
etc.
D. Behavior on a Continuum
the book does a very good job of explaining how behavior can be
viewed on a continuum from normal to abnormal as opposed to ONLY
normal or abnormal.
WHY is this important:
1. It is difficult to accurately distinguish normal from abnormal
2. On occasion don't we all have some personal distress?
3. We have ALL displayed some abnormal behavior at some point in our lives
**the key is how much of each and how often do they occur.
E. What causes abnormality? Models of Abnormality. 1. Medical model: mental illness/also referred to as Biological Model
a. illness idea (abnormal behavior, maladaptive behavior, mental
disorder, psychopathology, emotional disturbance, behavior disorder,
mental illness, mental disease, insanity)
b. organic, yes: alcoholics, senility, strokes,
c. functional, ?: no link to physical factors
2. Psychoanalytic - all disorders due to internal problems/turmoil.
He related ALL neuroses (abnormal behavior caused by anxiety) to the
Oedipul Complex.
3. Learning Model
stems from Bandura's social learning theory - behavior is the result
of observation and imitation of others.
4. Cognitive Model
thought processes cause distress - follows the Psychosomatic Model
5. Legal Model
if you break the rules or laws determined by society you may be considered psychologically imbalanced. In fact, many say that the legal definition of "insanity" is being incapable of standing trial.
II. How do psychologists identify disorders? The classification
problem: disorders (problems not clear cut) 1. DSM-IV of APA (uses a MULTIAXIAL system) *Axis = dimension
2. Axes I & II - used for diagnosis of disorders
a) Axis I - identification of major disorders
b) Axis II - identification of personality or developmental disorders (often comorbidity exists)
3. Remaining Axes are then used for supplemental information a) Axis III - physical problems b) Axis IV - severity of stress c) Axis V - current level of adaptive functioning The multiaxial system is a good thing - it attempts to show the BIG PICTURE of the person and not just focus on one "abnormal" or "unusual" factor, symptom, behavior, etc.
III. DISORDERS
A. Anxiety Disorders: All characterized by high (very high)
apprehension and anxiety, tension, and nervousness
1. Generalized anxiety disorder and panic
Consists of prolonged, vague, unexplained but intense fears that do
not seem to be attached to any particular object.
* very much like regular fears, but no actual danger
* objective anxiety vs. free-floating anxiety
* tense, apprehensive (concerns about future), difficulty
concentrating, irritable, worried, can't concentrate
* headaches, insomnia, upset stomach, aching muscles, need
to much sleep, sweating, dizziness, etc.
* Hypervigilance - always scanning the area for danger although
none usually exists.
* GAD - anxiety persists for at least 1 month (usually longer)
and is not attributable to recent life experiences (although
they may play a role)
2. Panic disorder
* severe anxiety moments
* "nervous breakdown," a case of the nerves
3. Phobias: an intense, recurrent, unreasonable fear of a specific
object or situation which leads to avoidance of the object or
situation
a) Simple Phobias (relatively rare) - an isolated fear of a single
object or situation that results in avoidance
* miscellaneous category comprising irrational fears that don't fall
under any other category. For example - claustrophobia
b) Social Phobias - characterized by fear and embarrassment in
dealings with others. Often the fear is that their anxiety will be
seen by others.
Examples: public speaking, eating in public, interpersonal
relationship fears (asserting one's self, criticism, making a
mistake, etc).
4. obsessive-compulsive
a. obsessions: persistent, irrational thought that
presses itself into awareness at odd times, idea
that keeps returning
* often involve doubt, hesitation, fear of contamination, or fear of one's own aggressions
b. compulsion: action that is continually repeated,
e.g., mother with obsession seeing herself stabbing
kids, leads to counting up knives, keeping them
locked
* most common compulsive behaviors: counting, ordering, checking, touching, and washing
* some are purely mental rituals like reciting a series of magical numbers to ward off obsessive thoughts
* Most Common Features:
- obsession or compulsion keeps getting into awareness
- feelings of anxiety or dread occurs if the act/thought is thwarted
- seen as a separate being, not part of one's self, and is uncontrollable
- person realizes how irrational their behavior is but can't stop
- person feels the need to resist
* variety of rituals is endless, but there are 4 main types of preoccupations:
- checking - doors, stoves, etc.
- cleaning - refuse to use public phones, restrooms, etc., vacuum all day long
- slowness - can't get through other tasks - preoccupied with compulsion
- doubting OR conscientiousness - even when something is done carefully they feel it was inadequate.
* Twin studies have indicated some support for the genetic basis
B. Somatoform disorders
1. Hypocondriasis: incessant worrying over health (not
actual, physical illness as in stress-induced illness
like ulcers)
2. Conversion (loss of sensory functions): not psychosomatic
illness, real loss
e.g., glove anesthesia, "hysterical blindness"
C. Dissociative: several varieties, all ways to keep
information about self out, lock things away, loss of
identity
1. Amnesia: forgetting past
2. fugue states: flight away from life, self: sometimes
short, sometimes long
3. multiple personality
not same as a split personality, three faces of Eve
D. Affective/Mood Disorders
definition - disturbances in mood or emotionality not due to any physical or mental disorder (no bereavement, anxiety disorder, etc).
There are essentially 2 types: Depressive disorder, and Bipolar disorder
1. Depressive Disorder (unipolar)- persistent feelings of sadness and despair, and a loss of interest in previously enjoyable activities/events. Also may include: marked weight loss, sleep problems, unclear thinking, etc.
*a depressive episode must last for at least 2 weeks for classification. Then, if there are 2 episodes of at least 2 week episodes, the person is diagnosed with Major Depression:
a) Major Depression
1) Extreme unhappiness, may be attributed to some specific
factor, but prolonged
2) some changes from normal to depressed
Item Normal Depressed
friends affection loss of feeling,
revulsion
favorite activity pleasure boredom
new opportunities enthusiasm indifference
humor amusement mirthlessness
novel stimuli curiosity lack of interest
abuse anger self-criticism
goal-gratification pleasure avoidance
welfare self-care self-neglect
self-preservation survival suicide
achievement success withdrawal
thoughts about self realistic self-devaluant
thoughts of future hopeful hopeless
appetite hunger loss of appetite
sexuality desires loss of desire
sleep restful disturbed
energy spontaneous fatigued
If the depressive episode lasts for an extended period, person may be
classified as having:
b) Dysthymia: affect is not so negative, but very long-term
* like depression, except continous, chronic state
that has lasted for as much as two years (one year
for adolescents)--almost like a "depressive
personality disorder", with depression being a
fundamental part of the individual's personality
2. Bipolar Disorder (Manic-depressive)
a) shifts back and forth in emotion, from depression (as
described above to mania: extremely high amounts of
energy, excited
b) nature of the manic phase
* distinct period in which the predominant mood is
quite elevated, it may look euphoric and cheerful
to an uninvolved observer, but to those who know
the person well it is clearly excessive
* mania is usually accompanied by a decreased need
for sleep, person has lots of energy
* you see a dramatic impairment in the person's
functioning - they are bouncing off the walls,
agitated
* it's the opposite of depression in that you see the
manic excessively involved in pleasurable
activities, shopping sprees, hypersexuality
* their speech may be loud, rapid, difficult to
interrupt, and full of jokes and puns
c) Symptoms
1) depressed and pessimistic to uninhibited,
delusions of grandeur, wild ideas
2) slow, tired, no energy to enthusiasm,
excitement, energetic
c. speech slow to mile a minute talking, joking
d. sleeps a lot to little sleep
e. euphoric, happy to sadness
f. thinking is blocked, no ideas to wild
thoughts, ideas, bizarre behavior
E. Schizophrenia - actually part of a category of mental disorders
known as psychoses
psychosis - a disorder that involves alterations of perceptions,
thought, or consciousness. A psychotic person is said to be detached
from reality (not necessarily continuously) but believes their
perceptions to be true.
* most serious, 1 in 50 in U.S. (1% of poulation), 25%
of hospitalized mentally ill, high return rate,
usually under 35 when first admitted
* characterized by psychotic symptoms, which means a
loss of contact with reality
* the individual detaches from reality and develops
an elaborate inner world which is illogical and
fantastic
* also characterized by thought disorder, which
involves a kind of unraveling of thinking
processes, the person's associations become loose,
and language and communication become disturbed,
what they say makes no sense (WORD SALAD)
* why called split personality: split from reality,
doesn't react right; also, the self is split into
fragments (but this is NOT the same as multiple
personality)
1. Symptoms: best considered to be a group of
psychotic reactions
a) Deterioration of behavior - the person declines from a
previous level of functioning, "not himself"
e.g., example of Fred who went from being an honor
student in school, to failing grades, getting into
trouble, and using drugs over a two year period
until finally having psychotic breakdown at age 16
b) Irrational, disordered thought(delusions), incoherence
in ideas Delusions are beliefs or a belief system that a person
has which are almost certainly not true; thoughts
being broadcast from one's head often
these have religious content or the conviction that
one is being controlled by outside forces, e.g.,
